Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro

Detalhes bibliográficos
Autor(a) principal: Yamane, Thais Lira Cleto
Data de Publicação: 2019
Outros Autores: thaíscleto@yahoo.com.br
Tipo de documento: Dissertação
Idioma: por
Título da fonte: Biblioteca Digital de Teses e Dissertações da UERJ
Texto Completo: http://www.bdtd.uerj.br/handle/1/20719
Resumo: Acute Kidney Injury (AKI) is a potentially life-threatening condition, especially in patients at the extremes of life and when Renal Replacement Therapy (RRT) is required. Epidemiological studies worldwide report mortality between 11 and 63% in pediatric patients submitted to RRT. Among children who survive an episode of AKI, up to 60% may remain with some residual impair in renal function. The aim of this study was to describe the epidemiological aspects related to dialysis requiring AKI in patients aged 0 to 18 years in the state of Rio de Janeiro. A retrospective observational study was carried out from a secondary database containing data from 35,435 patient records of all age groups submitted to extracorporeal therapies in 135 hospitals in the city of Rio de Janeiro and metropolitan area. After applying the inclusion and exclusion criteria, 693 patients were selected for this study. Most of the patients were male (59.5%) and were aged less than 2 years (63%), with a mean age of 3 years and 9 months. The majority of the patients were attended in private hospitals (76.5%). Sixty-seven percent of the subjects had at least 1 comorbidity, and the presence of comorbidities was even more prevalent in neonates (88%). The main etiology for AKI was sepsis (58.4%), being the most frequent cause since 2002. The lethality found was 65.2%, being lower in patients over 12 years of age (50%). Factors associated with lethality were age and etiology. The highest age was confirmed as a protective factor for death (HR: 1.88 for death in neonates when compared to patients over 12 years of age). The etiologies most related to death were perinatal asphyxia followed by sepsis (HR: 5.28 for asphyxia and HR: 4.05 for sepsis when compared to primary kidney diseases). This study confirmed the high lethality associated with dialytic AKI in pediatric patients and brought important data about its main aspects, and may contribute to the planning of preventive measures aimed at improve the outcomes of this condition.
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spelling Suassuna, José Hermógenes Roccohttp://lattes.cnpq.br/0065381779108423Nogueira, Paulo Cesar Kochhttp://lattes.cnpq.br/4980474480271642Bregman, Rachelhttp://lattes.cnpq.br/7952357764139600Lago, Marcos Junqueira dohttp://lattes.cnpq.br/7733476742225474Barbosa, Arnaldo Pratahttp://lattes.cnpq.br/0957109003322672http://lattes.cnpq.br/5351927215308546Yamane, Thais Lira Cletothaíscleto@yahoo.com.br2023-12-01T14:57:18Z2019-06-18YAMANE, Thais Lira Cleto. Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro. 2019. 101 f. Dissertação (Mestrado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2019.http://www.bdtd.uerj.br/handle/1/20719Acute Kidney Injury (AKI) is a potentially life-threatening condition, especially in patients at the extremes of life and when Renal Replacement Therapy (RRT) is required. Epidemiological studies worldwide report mortality between 11 and 63% in pediatric patients submitted to RRT. Among children who survive an episode of AKI, up to 60% may remain with some residual impair in renal function. The aim of this study was to describe the epidemiological aspects related to dialysis requiring AKI in patients aged 0 to 18 years in the state of Rio de Janeiro. A retrospective observational study was carried out from a secondary database containing data from 35,435 patient records of all age groups submitted to extracorporeal therapies in 135 hospitals in the city of Rio de Janeiro and metropolitan area. After applying the inclusion and exclusion criteria, 693 patients were selected for this study. Most of the patients were male (59.5%) and were aged less than 2 years (63%), with a mean age of 3 years and 9 months. The majority of the patients were attended in private hospitals (76.5%). Sixty-seven percent of the subjects had at least 1 comorbidity, and the presence of comorbidities was even more prevalent in neonates (88%). The main etiology for AKI was sepsis (58.4%), being the most frequent cause since 2002. The lethality found was 65.2%, being lower in patients over 12 years of age (50%). Factors associated with lethality were age and etiology. The highest age was confirmed as a protective factor for death (HR: 1.88 for death in neonates when compared to patients over 12 years of age). The etiologies most related to death were perinatal asphyxia followed by sepsis (HR: 5.28 for asphyxia and HR: 4.05 for sepsis when compared to primary kidney diseases). This study confirmed the high lethality associated with dialytic AKI in pediatric patients and brought important data about its main aspects, and may contribute to the planning of preventive measures aimed at improve the outcomes of this condition.A Injúria Renal Aguda (IRA) é uma condição grave e potencialmente fatal, principalmente em pacientes nos extremos de vida e na sua forma de apresentação mais grave, que envolve a necessidade de Terapia Renal Substitutiva (TRS). Estudos epidemiológicos internacionais relatam mortalidade entre 11 e 63% em pacientes pediátricos submetidos a TRS. Entre as crianças que sobrevivem a um episódio de IRA, até 60% podem permanecer com alguma alteração residual na função renal. O objetivo do presente estudo foi descrever os aspectos epidemiológicos relacionados a IRA dialítica em pacientes de 0 a 18 anos no estado do Rio de Janeiro. Foi realizado um estudo observacional retrospectivo a partir de uma base de dados secundária que continha dados de 35.435 registros de atendimentos a pacientes de todas as faixas etárias submetidos a terapias extracorpóreas em 135 hospitais da cidade do Rio de Janeiro e região metropolitana no período de janeir de 2002 a dezembro de 2014. Após a aplicação dos critérios de inclusão e exclusão foram selecionados 693 pacientes para esse estudo. Foi observada maioria de pacientes do sexo masculino (59,5%) e faixa etária menor que 2 anos (63%), com idade média da amostra de 3 anos e 9 meses. A maioria dos pacientes foi atendida em hospitais da rede privada (76,5%). Sessenta e sete porcento dos indivíduos apresentavam pelo menos 1 comorbidade, sendo a presença de comorbidades ainda mais prevalente em neonatos (88%). A principal etiologia para IRA foi sepse (58,4%), sendo a causa mais frequente desde 2002. A letalidade encontrada foi de 65,2%, sendo menor em pacientes acima de 12 anos de idade (50%). Os fatores associados a letalidade foram a faixa etária e a etiologia. A maior idade se confirmou como fator protetor para a morte (HR: 1,88 para óbito em neonatos quando comparados a pacientes acima de 12 anos). As etiologias mais relacionadas ao óbito foram asfixia perinatal seguida de sepse (HR: 5,28 para asfixia e HR: 4,05 para sepse quando comparados com doenças renais primárias). Esse estudo confirmou a elevada letalidade associada a IRA dialítica em pacientes pediátricos e trouxe dados importantes sobre seus principais aspectos, podendo contribuir para o planejamento de medidas preventivas que visem melhorar os desfechos desta condição.Submitted by Heloísa CB/A (helobdtd@gmail.com) on 2023-12-01T14:57:18Z No. of bitstreams: 1 Dissertação - Thais Lira Cleto Yamane - 2019 - Completa.pdf: 12654970 bytes, checksum: e015c253be05752235bca976a089f8ab (MD5)Made available in DSpace on 2023-12-01T14:57:18Z (GMT). No. of bitstreams: 1 Dissertação - Thais Lira Cleto Yamane - 2019 - Completa.pdf: 12654970 bytes, checksum: e015c253be05752235bca976a089f8ab (MD5) Previous issue date: 2019-06-18application/pdfporUniversidade do Estado do Rio de JaneiroPrograma de Pós-Graduação em Ciências MédicasUERJBrasilCentro Biomédico:Faculdade de Ciências MédicasAcute kidney injuryRenal replacement therapyChildrenAdolescentInjúria Renal AgudaLesão Renal AgudaTerapia de Substituição RenalTerapia Renal SubstitutivaCriançaAdolescenteCIENCIAS DA SAUDE::MEDICINAAspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de JaneiroEpidemiology of acute kidney injury in children in Rio de Janeiroinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/masterThesisinfo:eu-repo/semantics/openAccessreponame:Biblioteca Digital de Teses e Dissertações da UERJinstname:Universidade do Estado do Rio de Janeiro (UERJ)instacron:UERJORIGINALDissertação - Thais Lira Cleto Yamane - 2019 - Completa.pdfDissertação - Thais Lira Cleto Yamane - 2019 - Completa.pdfapplication/pdf12654970http://www.bdtd.uerj.br/bitstream/1/20719/2/Disserta%C3%A7%C3%A3o+-+Thais+Lira+Cleto+Yamane+-+2019+-+Completa.pdfe015c253be05752235bca976a089f8abMD52LICENSElicense.txtlicense.txttext/plain; charset=utf-82123http://www.bdtd.uerj.br/bitstream/1/20719/1/license.txte5502652da718045d7fcd832b79fca29MD511/207192024-02-26 15:59:51.561oai:www.bdtd.uerj.br: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Biblioteca Digital de Teses e Dissertaçõeshttp://www.bdtd.uerj.br/PUBhttps://www.bdtd.uerj.br:8443/oai/requestbdtd.suporte@uerj.bropendoar:29032024-02-26T18:59:51Biblioteca Digital de Teses e Dissertações da UERJ - Universidade do Estado do Rio de Janeiro (UERJ)false
dc.title.por.fl_str_mv Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
dc.title.alternative.eng.fl_str_mv Epidemiology of acute kidney injury in children in Rio de Janeiro
title Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
spellingShingle Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
Yamane, Thais Lira Cleto
Acute kidney injury
Renal replacement therapy
Children
Adolescent
Injúria Renal Aguda
Lesão Renal Aguda
Terapia de Substituição Renal
Terapia Renal Substitutiva
Criança
Adolescente
CIENCIAS DA SAUDE::MEDICINA
title_short Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
title_full Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
title_fullStr Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
title_full_unstemmed Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
title_sort Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro
author Yamane, Thais Lira Cleto
author_facet Yamane, Thais Lira Cleto
thaíscleto@yahoo.com.br
author_role author
author2 thaíscleto@yahoo.com.br
author2_role author
dc.contributor.advisor1.fl_str_mv Suassuna, José Hermógenes Rocco
dc.contributor.advisor1Lattes.fl_str_mv http://lattes.cnpq.br/0065381779108423
dc.contributor.advisor-co1.fl_str_mv Nogueira, Paulo Cesar Koch
dc.contributor.advisor-co1Lattes.fl_str_mv http://lattes.cnpq.br/4980474480271642
dc.contributor.referee1.fl_str_mv Bregman, Rachel
dc.contributor.referee1Lattes.fl_str_mv http://lattes.cnpq.br/7952357764139600
dc.contributor.referee2.fl_str_mv Lago, Marcos Junqueira do
dc.contributor.referee2Lattes.fl_str_mv http://lattes.cnpq.br/7733476742225474
dc.contributor.referee3.fl_str_mv Barbosa, Arnaldo Prata
dc.contributor.referee3Lattes.fl_str_mv http://lattes.cnpq.br/0957109003322672
dc.contributor.authorLattes.fl_str_mv http://lattes.cnpq.br/5351927215308546
dc.contributor.author.fl_str_mv Yamane, Thais Lira Cleto
thaíscleto@yahoo.com.br
contributor_str_mv Suassuna, José Hermógenes Rocco
Nogueira, Paulo Cesar Koch
Bregman, Rachel
Lago, Marcos Junqueira do
Barbosa, Arnaldo Prata
dc.subject.eng.fl_str_mv Acute kidney injury
Renal replacement therapy
Children
Adolescent
topic Acute kidney injury
Renal replacement therapy
Children
Adolescent
Injúria Renal Aguda
Lesão Renal Aguda
Terapia de Substituição Renal
Terapia Renal Substitutiva
Criança
Adolescente
CIENCIAS DA SAUDE::MEDICINA
dc.subject.por.fl_str_mv Injúria Renal Aguda
Lesão Renal Aguda
Terapia de Substituição Renal
Terapia Renal Substitutiva
Criança
Adolescente
dc.subject.cnpq.fl_str_mv CIENCIAS DA SAUDE::MEDICINA
description Acute Kidney Injury (AKI) is a potentially life-threatening condition, especially in patients at the extremes of life and when Renal Replacement Therapy (RRT) is required. Epidemiological studies worldwide report mortality between 11 and 63% in pediatric patients submitted to RRT. Among children who survive an episode of AKI, up to 60% may remain with some residual impair in renal function. The aim of this study was to describe the epidemiological aspects related to dialysis requiring AKI in patients aged 0 to 18 years in the state of Rio de Janeiro. A retrospective observational study was carried out from a secondary database containing data from 35,435 patient records of all age groups submitted to extracorporeal therapies in 135 hospitals in the city of Rio de Janeiro and metropolitan area. After applying the inclusion and exclusion criteria, 693 patients were selected for this study. Most of the patients were male (59.5%) and were aged less than 2 years (63%), with a mean age of 3 years and 9 months. The majority of the patients were attended in private hospitals (76.5%). Sixty-seven percent of the subjects had at least 1 comorbidity, and the presence of comorbidities was even more prevalent in neonates (88%). The main etiology for AKI was sepsis (58.4%), being the most frequent cause since 2002. The lethality found was 65.2%, being lower in patients over 12 years of age (50%). Factors associated with lethality were age and etiology. The highest age was confirmed as a protective factor for death (HR: 1.88 for death in neonates when compared to patients over 12 years of age). The etiologies most related to death were perinatal asphyxia followed by sepsis (HR: 5.28 for asphyxia and HR: 4.05 for sepsis when compared to primary kidney diseases). This study confirmed the high lethality associated with dialytic AKI in pediatric patients and brought important data about its main aspects, and may contribute to the planning of preventive measures aimed at improve the outcomes of this condition.
publishDate 2019
dc.date.issued.fl_str_mv 2019-06-18
dc.date.accessioned.fl_str_mv 2023-12-01T14:57:18Z
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dc.identifier.citation.fl_str_mv YAMANE, Thais Lira Cleto. Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro. 2019. 101 f. Dissertação (Mestrado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2019.
dc.identifier.uri.fl_str_mv http://www.bdtd.uerj.br/handle/1/20719
identifier_str_mv YAMANE, Thais Lira Cleto. Aspectos epidemiológicos da injúria renal aguda dialítica em pacientes pediátricos no Rio de Janeiro. 2019. 101 f. Dissertação (Mestrado em Ciências Médicas) – Faculdade de Ciências Médicas, Universidade do Estado do Rio de Janeiro, Rio de Janeiro, 2019.
url http://www.bdtd.uerj.br/handle/1/20719
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dc.publisher.program.fl_str_mv Programa de Pós-Graduação em Ciências Médicas
dc.publisher.initials.fl_str_mv UERJ
dc.publisher.country.fl_str_mv Brasil
dc.publisher.department.fl_str_mv Centro Biomédico:Faculdade de Ciências Médicas
publisher.none.fl_str_mv Universidade do Estado do Rio de Janeiro
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